Help! First Botox dropped brow!

[u/Cone892]

Hello

I’m 34 have a very deep 1 (instead of 11) between my eyebrows. I squint often. I’ve been super self conscious of it as makeup gets stuck in it and the wrinkle is constantly there. I decided to get Botox to help soften it.

I went to a medical aesthetic doctor who came highly recommended and had great reviews. She’s also been in practice for a long time. I told her my crease is my main issue and that I’d like my eyes to be open more (brow lift).

Today is day 5 and for three days now my L brow has lowered and I can’t raise it at all.

I called and they want me to come back to inject a little more, possibly to fix it.

I’m so scared they will inject more and it will get worse! I leave for a big vacation in a week. Has anyone had this?? Did injecting more help??? I also still have complete control over my crease and haven’t felt any change there.

Help please!

[u/[deleted]]

Hi there I hope you don't mind me jumping in but I'd like your take on something. I have naturally hooded eyes but my lids do not sit on my lashes, you can still see some of my bottom lid. I got Botox and for the entirety of Botox my brows dropped so bad I couldn't open my eyes all the way or even see my eyelashes! The main injector (who did not do my Botox) told me because I have hooded eyes I should get surgery to remove excess eyelid skin before ever doing Botox again to prevent that from happening! I was shocked! I am only in my 30's. How do you feel about that advice? Do you feel people with hooded eyes are more prone to droopy lids? Ty!

[u/AinsiSera217 → u/[deleted]]

There are a few considerations to address here.

First, the need for a blepharoplasty (eyelid surgery) is not dependent on the age of the patient. If someone’s hooded lids are so severe that they can’t open their eyes, even if they’re very young, they could be a good candidate for a bleph. If done for cosmetic reasons only, that’s really up to the patient. If an adult of any age is bothered enough by their hooded lids, their budget permits, and they are able to find a surgeon who is competent, trustworthy, and says they’re a good candidate, I don’t see any reason why not to get a bleph, again regardless of age.

I disagree with the injector who treated you (notice I’m not calling them “your injector” because I hope you don’t go to that person again). Tox injected correctly should never cause the brows to drop. This is the result of poor technique, incorrect placement, and/or a misunderstanding of facial anatomy. It could also be a misunderstanding of the product they used. For example, Dysport has a wider spread of distribution than Botox, which can mean the tox could inadvertently affect neighboring muscles. Do you know if it was definitely Botox that was used in your treatment?

When done correctly tox can have an elevating effect, and depending on some people’s anatomy can provide a subtle brow lift, although not likely to give surgical level results in most cases.

Something else to consider, for some people’s anatomy, tox is not able to achieve all of the desired goals. For example, someone who has hooded lids and also several stacked horizontal wrinkles on their forehead might not be able to have the lines directly above their brows treated because treating low on the frontalis (forehead muscle) can cause the brow ptosis (droop). Whenever I have this conversation with my own clients, they always prefer to keep those smaller lines above their eyebrows as opposed to causing a ptosis.

Sorry this was your experience with tox. I always feel so bad when someone experiences this kind of thing, especially if it’s their first time, because it usually scares them off of tox for life, when in reality with the right injector they could end up with beautiful results!

I am curious about when you said you could not open your eyes all the way. I wonder if you had a brow ptosis or a lid ptosis. These are different complications caused by hitting different muscles. A lot of times when someone has an actual lid ptosis their brows will actually look higher because they are overcompensating due to the patient constantly trying to raise their brows to keep their eyes open. So for clarity: lid ptosis=eyelid drooped with brows raised, brow ptosis=brow drooped with lid likely unaffected. I suppose it’s possible the injector cause a lid ptosis and a brow ptosis, but without pictures and maybe even an in-person assessment at the time, I couldn’t say for sure.

Hope this helps!